Policy Details

5145.5 FORM 1 Sexual Discrimination/Harassment

Regulation 5145.5
Form 1

Litchfield Public Schools
35 Wamogo Road ~ Litchfield, Connecticut ~ 06759


SEXUAL DISCRIMINATION / HARASSMENT COMPLAINT
LITCHFIELD PUBLIC SCHOOLS (Students)

Name of the complainant

Date of the complaint Date(s) of alleged harassment

Name or names of the alleged harasser(s)



Location(s) where alleged harassment occurred





Name(s) of any witness(es) to the alleged harassment



Detailed statement of the circumstances constituting the alleged discrimination or harassment




Remedy Requested

Litchfield Board of Education
Form Developed: 1/14/2021

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